Less Is More

Simpler & Better Medicine

Apabetalone and MACE for patients with type 2 diabetes and recent ACS. — June 2, 2020

Apabetalone and MACE for patients with type 2 diabetes and recent ACS.

Summary: For patients with type 2 diabetes, low HDL cholesterol levels, and a recent acute coronary syndrome (ACS), and approach of not adding apabetalone to standard care may be associated with the same risk of cardiovascular death, nonfatal myocardial infarction, or stroke over approximately 2 years of follow-up as an approach of adding apabetalone to standard therapy; however use of apabetalone may be associated with a higher risk of having elevated liver enzymes.

https://pubmed.ncbi.nlm.nih.gov/32219359/

Strength of Recommendation = B

Paracetamol or combination analgesics for musculoskeletal injuries. — May 5, 2020

Paracetamol or combination analgesics for musculoskeletal injuries.

Summary: For patients with an acute limb or trunk injury, use of 1 gram of paracetamol alone for analgesia may be associated with the same degree of pain relief at 1 and 2 hours as the use of 1 g paracetamol + 400 mg ibuprofen + 60 mg codeine but paracetamol alone may be associated with a lower rate of adverse events than combination analgesia.

https://pubmed.ncbi.nlm.nih.gov/31378383/

Strength of Recommendation = B

Dosing of oral ibuprofen for acute pain in the emergency department. — April 28, 2020
Bedtime hypertension treatment can improve cardiovascular risk reduction. — April 21, 2020

Bedtime hypertension treatment can improve cardiovascular risk reduction.

Summary: For individuals with high blood pressure, taking blood pressure medications at bed-time may reduce the risk of cardiac death, heart attack, stroke and heart failure by about half compared to taking blood pressure medications in the morning without any increase in reported adverse effects.

https://pubmed.ncbi.nlm.nih.gov/31641769/

Strength of Recommendation = B

Feeding evaluation and frenotomy rates in infants with breastfeeding difficulties. — March 10, 2020

Feeding evaluation and frenotomy rates in infants with breastfeeding difficulties.

Summary: For infants with breastfeeding difficulties that are suspected to be due to ankyloglossia (tongue-tie), a comprehensive multidisciplinary feeding evaluation prior prior to surgical consultation may be associated with about a 60 percent reduction in the likelihood of having subsequent surgical frenotomy.

https://www.ncbi.nlm.nih.gov/m/pubmed/31294774/

Strength of Recommendation = B

Intravenous or oral proton pump inhibitor therapy for bleeding peptic ulcers following endoscopic management. — March 3, 2020

Intravenous or oral proton pump inhibitor therapy for bleeding peptic ulcers following endoscopic management.

Summary: For patients with symptoms of a bleeding peptic ulcer, post-endoscopy treatment with an oral proton-pump inhibitor (PPI) may be associated with no difference in risk of re-bleeding compared to treatment with an intravenous PPI; however treatment with ahigh-dose oral PPI may be associated with a lower transfusion requirement compared to use of a high-dose intravenous PPI.

https://www.ncbi.nlm.nih.gov/m/pubmed/28181291/

Strength of Recommendation = B

Polygenic vs clinical risk prediction of coronary heart disease. — February 25, 2020
Conservative or interventional treatment for spontaneous pneumothorax. — February 18, 2020

Conservative or interventional treatment for spontaneous pneumothorax.

Summary: For stable patients with spontaneous pneumothorax, a conservative-management approach (observation and close clinical followup) might be associated with the same likelihood of lung re-expansion at 8 weeks and a lower likelihood of adverse events or pneumothorax recurrence compared to an interventional-management approach (immediate chest-tube placement).

https://www.ncbi.nlm.nih.gov/m/pubmed/31995686/

Strength of Recommendation = B

Interventions for aggressive and agitated behaviors in dementia. — February 11, 2020
Pharmacologic interventions to prevent cognitive decline, mild cognitive impairment, and clinical alzheimer dementia. — February 4, 2020

Pharmacologic interventions to prevent cognitive decline, mild cognitive impairment, and clinical alzheimer dementia.

Summary: For patients with normal cognition, those who avoid the use of estrogens and estrogen-progestin combination medications may be associated with a lower risk of mild cognitive impairment (MCI) or dementia compared to those who take these medications, and patients who use estrogen-progestin combination medications may be at higher risk of stroke, coronary heart disease, invasive breast cancer, and pulmonary embolism than those who avoid them.

Evidence related to the use of other medications (anti-hypertensives, diabetes medications, NSAIDs, aspirin, and lipid-lowering medications) is conflicting. 

https://www.ncbi.nlm.nih.gov/m/pubmed/29255847/

Strength of Recommendation = A

Use of no advanced airway vs intubation vs supraglottic airway in out-of-hospital cardiac arrest. — January 28, 2020

Use of no advanced airway vs intubation vs supraglottic airway in out-of-hospital cardiac arrest.

Summary: For adults suffering out-of-hospital cardiac arrest (OHCA), data from the Cardiac Arrest Registry to Enhance Survival (CARES) suggests that avoiding the use of an advanced airway may be associated with a higher likelihood of survival to hospital admission, hospital survival  and hospital discharge with a good neurologic outcome compared to resuscitation with endotracheal intubation or use of a supraglottic airway.

https://www.ncbi.nlm.nih.gov/m/pubmed/24561079/

Strength of Recommendation = B

Ultrasonography + mammography for breast cancer screening. — January 21, 2020

Ultrasonography + mammography for breast cancer screening.

Summary: For women undergoing breast imaging for cancer screening, use of mammography alone and use of mammography + ultrasonography are both associated with the same cancer detection rate (~ 5.5 per 1000 screens); while use of mammography alone may be associated with a lower false positive biopsy rate (~ 22 per 1000 screens) compared to mammography + ultrasonography (~52 per 1000 screens).

https://www.ncbi.nlm.nih.gov/m/pubmed/30882843

Strength of Recommendation = B

Ibuprofen with or without Metaxalone, Tizanidine, or Baclofen for Acute Low Back Pain — January 14, 2020

Ibuprofen with or without Metaxalone, Tizanidine, or Baclofen for Acute Low Back Pain

Summary: For patients with non-radicular low back pain of less than 2 weeks’ duration, treatment with ibuprofen 600 mg 3x daily as needed for 1 week may be associated with the same level of symptomatic improvement after 1 week as treatment with ibuprofen plus a muscle-relaxant 3x daily as needed (specifically, metaxalone, tizanidine, or baclofen); however treatment with ibuprofen alone allows consumption of fewer medications.

https://www.ncbi.nlm.nih.gov/m/pubmed/30955985/

Strength of Recommendation = B

Ticagrelor or aspirin after coronary artery bypass grafting. — January 7, 2020

Ticagrelor or aspirin after coronary artery bypass grafting.

Summary: For patients who have had coronary artery bypass grafting (CABG), treatment with aspirin 100 mg daily may be associated with a lower risk of bleeding and with lower costs compared to ticagrelor (90 mg twice daily); rates of all-cause and cardiovascular mortality do not appear to differ between the treatment approaches.

https://www.ncbi.nlm.nih.gov/m/pubmed/31145798/

Strength of Recommendation = B

Penicillin for 5 or 10 days for Group A streptococcal pharnygitis. — December 31, 2019

Penicillin for 5 or 10 days for Group A streptococcal pharnygitis.

Summary: For patients over age 6 years with group A streptococcal pharnygitis meeting at least 3 of the Centor Criteria, treatment with Penicillin V 800 mg 4x daily for 5 days may be associated with a slightly shorter time to relief of symptoms and a lower likelihood of adverse events such as diarrhea, nausea, and vulvovaginal symptoms compared to treatment with Penicillin V 1000 mg 3x daily for 10 days; both approaches may be associated with the same likelihood (~ 90%) of clinical cure after 5-7 days.

https://www.ncbi.nlm.nih.gov/m/pubmed/31585944/

Strength of Recommendation = A

Echocardiography for adults after an acute myocardial infarction. — December 24, 2019

Echocardiography for adults after an acute myocardial infarction.

Summary: For hospitals admitting patients with acute myocardial infarction (AMI), lower  rates of trans-thoracic echocardiography (TTE) during hospitalizations for AMI may be associated with slightly shorter length-of-stay compared to hospitals with higher rates of TTE, without any increased rates of mortality or readmission.

https://www.ncbi.nlm.nih.gov/m/pubmed/31206134/

Strength of Recommendation = B

Stenting + medical therapy vs medical therapy alone for stable coronary artery disease. — December 17, 2019

Stenting + medical therapy vs medical therapy alone for stable coronary artery disease.

Summary: For patients with stable coronary artery disease (CAD), using optimal medical therapy without stenting compared to optimal medical therapy WITH stenting may both be associated with the same rates of death (~ 9%), non-fatal myocardial infarction (~8-9%) and persistent angina (~29-33%) over about 4 years of follow up; while an approach of treating stable coronary artery disease with optimal medical therapy alone may be associated with fewer total interventional procedures.

https://www.ncbi.nlm.nih.gov/m/pubmed/22371919/

Strength of Recommendation = A

Early or delayed cardioversion in recent-onset atrial fibrillation. — December 10, 2019

Early or delayed cardioversion in recent-onset atrial fibrillation.

Summary: For adult patients with symptomatic, recent-onset, and hemodynamically stable atrial fibrillation, a “wait-and-see” approach (provision of rate control medications and follow up in approximately 48 hours with cardioversion if still in atrial fibrillation) may be associated with the same likelihood of sinus rhythm at 4 weeks, the same likelihood of hospital admission or return visits to the emergency room, but a lower likelihood of needing electrical or pharmacologic cardioversion compared to an approach of early cardioversion (either electrical or pharmacologic).

https://www.ncbi.nlm.nih.gov/m/pubmed/30883054/

Strength of Recommendation = B

Antipsychotics and Preventing Delirium in Hospitalized Adults. — December 3, 2019
N95 Respirators or Medical Masks for Preventing Influenza Among Health Care Personnel. — November 26, 2019

N95 Respirators or Medical Masks for Preventing Influenza Among Health Care Personnel.

Summary: For health care personnel working near patients during the peak season for viral respiratory illnesses use of routine medical masks may be associated with the same risk of developing laboratory confirmed influenza, acute respiratory illness, or influenza-like illness as use of N95 respirators; while standard medical masks are both simpler to use and less costly than N95 respirators.

https://www.ncbi.nlm.nih.gov/m/pubmed/31479137/

Strength of Recommendation = B

Asymptomatic Bacteriuria in Hospitalized Patients. — November 19, 2019

Asymptomatic Bacteriuria in Hospitalized Patients.

Summary: For hospitalized medical patients with asymptomatic bacteriuria (ASB), ie a positive urine culture without any documented signs or symptoms attributable to urinary tract infection, treatment of ASB with antibiotics may be associated with a longer hospital stay (approximately 4 days vs approximately 3 days) without any improvement in other hospitalization-related outcomes.

https://www.ncbi.nlm.nih.gov/m/pubmed/31449295/

Strength of Recommendation = B

Long-term survival with chest-compression only CPR vs standard CPR. — November 12, 2019

Long-term survival with chest-compression only CPR vs standard CPR.

Summary: For individuals receiving bystander cardiopulmonary resuscitation (CPR) in the community, use of chest compressions alone compared to chest compressions + rescue breathing may be associated with a higher likelihood of survival at 1, 2, and 5 years after arrest (NNT approximately 2 at each outcome interval).

https://www.ncbi.nlm.nih.gov/m/pubmed/23230313/

Strength of Recommendation = B

Linagliptin, Glimepiride and Cardiovascular Outcomes in Patients With Type 2 Diabetes. — November 5, 2019

Linagliptin, Glimepiride and Cardiovascular Outcomes in Patients With Type 2 Diabetes.

Summary: For people with type 2 diabetes and an elevated risk of cardiovascular disease, treatment with glimepiride or treatment with linagliptin may both be associated with the same rate of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke (about 12%) over approximately 6 years of follow up; however glimepiride is much less expensive than linagliptin.

https://www.ncbi.nlm.nih.gov/m/pubmed/31536101/

Strength of Recommendation = B

Oxygen vs Room Air for Intrauterine Fetal Resuscitation. — October 29, 2019

Oxygen vs Room Air for Intrauterine Fetal Resuscitation.

Summary: For women in labor at term (> 37 weeks gestational age) who develop category II fetal heart rate tracings requiring intrauterine resuscitation, use of “room air” for the mother may be associated with the same subsequent level of umbilical artery lactate as use of oxygen 10 LPM by face mask for the mother, without any increased rates of operative or cesarean delivery.

https://www.ncbi.nlm.nih.gov/m/pubmed/30039159/

Strength of Recommendation = B

Subjective Memory Complaints, Simple Memory Task Scores, and Future Dementia. — October 22, 2019

Subjective Memory Complaints, Simple Memory Task Scores, and Future Dementia.

Summary: For older individuals dwelling in the community, the presence of subjective memory complaints (“Yes” to the question “Do you feel you have more problems with memory than most?”) may be more predictive of future dementia than imperfect scores on the Mini-Mental State Examination delayed recall item and the Visual Association Test (VAT).

https://www.ncbi.nlm.nih.gov/m/pubmed/31501202/

Strength of Recommendation = B

Outcomes After Intensifying Antihypertensive Medication Regimens Among Older Adults at Hospital Discharge. — October 15, 2019

Outcomes After Intensifying Antihypertensive Medication Regimens Among Older Adults at Hospital Discharge.

Summary: For patients over age 65 hospitalized for non-cardiac conditions, discharge without adding to the pre-hospital list of antihypertensive medications may be associated with a lower risk of 30-day readmission and a lower risk of serious adverse events compared to discharge with increased dosing of or medications for blood pressure control, without any increase in systolic blood pressure or cardiovascular events over the subsequent year.

https://www.ncbi.nlm.nih.gov/m/pubmed/31424475/

Strength of Recommendation = B

Nonfasting vs Fasting Lipid Levels and Major Coronary Events in ASCOT-LLA — October 8, 2019

Nonfasting vs Fasting Lipid Levels and Major Coronary Events in ASCOT-LLA

Summary: For patients having lipid levels measured for coronary risk assessment in primary prevention there may be no significant difference in coronary risk prediction between fasting and non-fasting lipid levels, while using non-fasting lipid levels is an approach that is less burdensome to patients.

https://www.ncbi.nlm.nih.gov/m/pubmed/31135812/

Strength of Recommendation = B

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel. — September 24, 2019

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel.

Summary: For health-care professionals (HCPs) working in outpatient settings during the peak of viral respiratory season, use of standard medical masks when near patients with respiratory illnesses may be associated with the same risk of developing a laboratory-confirmed influenza infection (~ 7-8%) and the same risk of developing an influenza-like illness (~ 5-8%) as is use of a N95 respirator; while standard medical masks are both simpler to use and less costly than N95 respirators.

https://www.ncbi.nlm.nih.gov/m/pubmed/31479137/

Strength of Recommendation = B

Routine preoperative medical testing for cataract surgery. — September 10, 2019

Routine preoperative medical testing for cataract surgery.

Summary: For patients undergoing cataract surgery, using an approach of either no preoperative testing or selective preoperative testing may be associated with reducing costs to approximately 40% of the costs associated with routine preoperative testing without any increased rates of adverse events or surgical cancellations.

https://www.ncbi.nlm.nih.gov/m/pubmed/30616299/

Strength of Recommendation = A

Buddy taping vs plaster immobilization for adults with uncomplicated fracture of the neck of the fifth metacarpal. — August 27, 2019

Buddy taping vs plaster immobilization for adults with uncomplicated fracture of the neck of the fifth metacarpal.

Summary: For adults with an uncomplicated “boxer’s fracture” (fracture of the 5th metacarpal), “buddy taping” of the ring and little fingers on the affected side for at least 3 weeks may be associated with the same level of hand function at 12 weeks as treatment with plaster immobilization for at least 3 weeks; while buddy-taping may be associated with less time missed from work compared to plaster immobilization.

https://www.ncbi.nlm.nih.gov/m/pubmed/30853124/

Strength of Recommendation = B

Intensive vs standard treatment of hyperglycemia following acute stroke. — August 6, 2019

Intensive vs standard treatment of hyperglycemia following acute stroke.

Summary: For adult patients with acute stroke, management of hyperglycemia with sliding-scale subcutaneous insulin (titrated to a target glucose range of 80 – 179 mg/dL) may be associated with fewer patients (approximately 3 vs 11 out of 100) experiencing hypoglycemia compared to an approach of using continuous intravenous insulin (titrated to a target glucose range of 80 – 130 mg/dL), without any worsening of functional outcomes as measured by the modified Rankin scale.

https://www.ncbi.nlm.nih.gov/m/pubmed/31334795/

Strength of Recommendation = B

Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit. — July 30, 2019

Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit.

Summary: When patients are admitted to the intensive care unit (ICU), a policy of flexible family visitation (up to 12 hours per day) may be associated with lower anxiety and depression scores among family members compared to a policy of restricted visitation (< 4.5 hours per day) without affecting the incidence of ICU delirium ICU-acquired infections, or staff burnout.

https://www.ncbi.nlm.nih.gov/m/pubmed/31310297/

Strength of Recommendation = B

Vena Cava Filters in Severely Injured Patients. — July 23, 2019

Vena Cava Filters in Severely Injured Patients.

Summary: For severely injured patients who cannot receive prophylactic anticoagulation, an approach of not placing a prophylactic vena cava filter within the first 72 hours after admission may be associated with the same risks of symptomatic pulmonary embolism or death within 90 days as an approach of placing a vena cava filter in the first 72 hours after admission (approximately 14 out of 100 patients with either approach).

https://www.ncbi.nlm.nih.gov/m/pubmed/31259488/

Strength of Recommendation = B

Pharmacologic or nonpharmacologic treatments for urinary incontinence in women. — July 16, 2019
Duration of dual antiplatelet therapy after percutaneous coronary intervention with a drug-eluting stent. — July 9, 2019

Duration of dual antiplatelet therapy after percutaneous coronary intervention with a drug-eluting stent.

Summary: For patients with coronary artery disease (CAD) who have had percutaneous coronary intervention (PCI) with a drug-eluting stent (DES), dual-anti-platelet therapy (DAPT)  for less than 6 months may be associated with lower rates of major bleeding than DAPT for 12 months and lower rates of both major bleeding & non-cardiac death than DAPT for longer than 12 months, without any increased risk of cardiac death, all cause mortality, myocardial infarction, or stent thrombosis.

https://www.ncbi.nlm.nih.gov/m/pubmed/31253632/

Strength of Recommendation = A

Dual-antiplatelet therapy for one month vs 12 months. — July 2, 2019

Dual-antiplatelet therapy for one month vs 12 months.

Summary: For patients having percutaneous coronary intervention (PCI), one-month dual-antiplatelet therapy (DAPT) followed by clopidogrel monotherapy may be associated with a lower 12-month rates of major and minor bleeding (~ 4 per 1000) compared to continued DAPT with aspirin + clopidogrel (~15 per 1000), without any excess risk of of cardiovascular death, myocardial infarction (MI), ischemic or hemorrhagic stroke, stent thrombosis.

https://www.ncbi.nlm.nih.gov/m/pubmed/31237644/

Strength of Recommendation = B

Ultra-processed foods and mortality — June 25, 2019
Ultra-processed foods and cardiovascular disease — June 19, 2019
Noninvasive Cardiac Testing vs Clinical Evaluation Alone in Acute Chest Pain. — June 4, 2019

Noninvasive Cardiac Testing vs Clinical Evaluation Alone in Acute Chest Pain.

Summary: For patients presenting to emergency care with acute chest pain, use of clinical evaluation alone (history, examination, electrocardiogram, and biomarker assessment) may be associated with shorter lengths of stay in the emergency room,  as well as lower rates of diagnostic testing, lower costs, and lower cumulative radiation exposure over 28 days of follow up compared to an approach of adding noninvasive testing to clinical evaluation as part of the standard emergency care evaluation of chest pain; and use of clinical evaluation alone without non-invasive testing does not appear to be associated with any higher rates of return emergency visits or major adverse cardiac events over 28 days of followup.

https://www.ncbi.nlm.nih.gov/m/pubmed/29138794/

Strength of Recommendation = B

Bladder Training Video or Standard Urotherapy for Bladder and Bowel Dysfunction. — May 28, 2019

Bladder Training Video or Standard Urotherapy for Bladder and Bowel Dysfunction.

Summary: For children between the ages of 5 and 10 years in need of “urotherapy” for bladder and bowel dysfunction, use of a bladder training video rather than standard urotherapy can allow free access for subsequent review of the video; and use of a video for bowel and bladder training does not appear to be any less effective at reducing symptom scores than use of standard urotherapy.

https://www.ncbi.nlm.nih.gov/m/pubmed/27569433/

Strength of Recommendation = B

Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source. — May 21, 2019

Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source.

Summary: For patients with an embolic stroke of undetermined source, use of aspirin for secondary prevention may be associated with a slightly lower risk of “clinically relevant nonmajor bleeding” compared to use of dabigatran for secondary prevention; both aspirin and dabigatran used for secondary prevention appear to have the same risks of risks of stroke recurrence and major bleeding over approximately 1.5 years of follow up.

https://www.ncbi.nlm.nih.gov/m/pubmed/31091372/

Strength of Recommendation = B

Delayed antibiotic prescribing strategies for respiratory tract infections in primary care. — May 14, 2019

Delayed antibiotic prescribing strategies for respiratory tract infections in primary care.

Summary: For patients with acute respiratory infections who are not judged clinically to need immediate antibiotic treatment, any of several “delayed antibiotic prescription” approaches are associated fewer patients using antibiotics compared to an approach of giving an immediate antibiotic prescription (approximately 3-4 out of 10 compared to 9 out of 10); while giving an immediate antibiotic prescription is not associated with any shorter duration of illness or any lower symptom scores.

https://www.ncbi.nlm.nih.gov/m/pubmed/24603565

Strength of Recommendation = B

Acute chest pain evaluation using coronary computed tomography angiography compared with standard of care. — May 7, 2019

Acute chest pain evaluation using coronary computed tomography angiography compared with standard of care.

Summary: For patients with acute chest pain, initial evaluation with physiologic testing is associated lower rates of invasive angiography and revascularization compared to initial evaluation with coronary CT angiography (CCTA); and initial evaluation with physiologic testing is not associated with any higher rates of all-cause mortality, myocardial infarction or major adverse cardiac events (MACE) compared to initial testing with CCTA.

https://www.ncbi.nlm.nih.gov/m/pubmed/28855273/

Strength of Recommendation = A

Rapid versus standard intravenous rehydration in pediatric gastroenteritis. — April 30, 2019

Rapid versus standard intravenous rehydration in pediatric gastroenteritis.

Summary: For children between 3 months and 11 years of age who have been prescribed intravenous rehydration due to gastroenteritis, standard rehydration (starting with 20 mL/kg 0.9% saline over the first hour) might be associated with a shorter average time to discharge (5 hours rather than 6.3 hours) than rapid rehydration (starting with 60 mL/kg 0.9% saline over the first hour) without any difference in the proportion of patients rehydrated after 2 hours.

https://www.ncbi.nlm.nih.gov/m/pubmed/22094316/

Strength of Recommendation = B

Antibiotic Prescribing for Acute Respiratory Tract Infections 12 Months After Communication and CRP Training. — April 16, 2019

Antibiotic Prescribing for Acute Respiratory Tract Infections 12 Months After Communication and CRP Training.

Summary: For primary care general practices caring for patients with suspected lower respiratory tract infections, training in communication is effective at maintaining reduced rates of antibiotic prescriptions over 12 months but training in C-reactive-protein (CRP) testing does not remain effective at 12 months for reducing rates of antibiotic prescribing.

https://www.ncbi.nlm.nih.gov/m/pubmed/30858255/

Strength of Recommendation = B

Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis. — April 9, 2019

Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis.

Summary: For adult patients admitted to a medical intensive care unit (ICU), use of pharmacologic thromboprophylaxis alone appears to be associated with the same rates of new proximal lower-limb deep-vein thrombosis (DVT), overall venous thromboembolism (pulmonary embolism or any DVT) and death as use of intermittent pneumatic compression (IPC) for at least 18 hours each day + pharmacologic thromboprophylaxis with unfractionated or low-molecular-weight heparin; while pharmacologic thromboprophylaxis alone might be associated with less patient dissatisfaction (6.4% of the patients in the IPC group had IPC withheld at patient or family request).

https://www.ncbi.nlm.nih.gov/m/pubmed/30779530/

Strength of Recommendation = B

Intensive or Standard Blood Pressure Control & Probable Dementia. — April 2, 2019

Intensive or Standard Blood Pressure Control & Probable Dementia.

Summary: For patients over age 50 with hypertension but without diabetes or a history of stroke, an approach of treating to a systolic blood pressure goal of less than 140 mmHg appears to be associated with the same risk of dementia over approximately 3 years’ follow up as an approach of treating to a systolic blood pressure goal of less than 120 mmHg (1); however treating to a systolic blood pressure goal of less than 120 mmHg may be associated with a higher risk of hypotension and possibly a higher risk of syncope (2).

(1) https://www.ncbi.nlm.nih.gov/m/pubmed/30688979/

(2) https://www.ncbi.nlm.nih.gov/m/pubmed/29601076/

Strength of Recommendation = B

 

Systolic Blood Pressure and Cognitive Decline in Older Adults With Hypertension — March 19, 2019

Systolic Blood Pressure and Cognitive Decline in Older Adults With Hypertension

Summary: For patients aged 75 years or older with complex health problems, treatment of hypertension to a systolic blood pressure (SBP) > 130 mmHg may be associated with a lower likelihood of cognitive decline over one year than treatment of hypertension to a (SBP) < 130 mmHg.

https://www.ncbi.nlm.nih.gov/m/pubmed/30858252/

Strength of Recommendation = B

Coffee Intake and Incident Chronic Kidney Disease — February 19, 2019
Metered Dose Inhalers vs Breath Actuated Nebulizers. — February 5, 2019

Metered Dose Inhalers vs Breath Actuated Nebulizers.

Summary: For children (aged 2-17 years) with an acute asthma exacerbation, administration of albuterol via metered-dose-inhaler (MDI) may not be any less effective for reducing the risk of hospital admission than administration of albuterol via breath-actuated-nebulizer (BAN); however use of MDI might be less costly than use of BAN.

https://www.ncbi.nlm.nih.gov/m/pubmed/29716819/

Strength of Recommendation = B

%d bloggers like this: